{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:09:44Z","timestamp":1777421384448,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T00:00:00Z","timestamp":1652918400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Corticosteroids and tocilizumab have been shown to improve survival in patients who require supplemental oxygen from coronavirus disease 2019 (COVID-19) pneumonia. The optimal dose of immunosuppression for the treatment of COVID-19 acute respiratory distress syndrome (ARDS) is still unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The objective of this study was to evaluate the effectiveness and safety of high- versus low-dose corticosteroids with or without tocilizumab for the treatment of COVID-19 ARDS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This was a retrospective study of patients admitted to the intensive care unit (ICU) requiring mechanical ventilation who received high- versus low-dose corticosteroids with or without tocilizumab. The primary outcome was survival to discharge. Safety outcomes included infections and incidence of hyperglycemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In this cohort, 110 (54%) and 95 (46%) patients received high-dose (\u226510 mg dexamethasone equivalent) and low-dose (&lt;10 mg dexamethasone equivalent) corticosteroids for more than 3 consecutive days, respectively. Thirty-five patients (32%) in the high-dose group and 33 patients (35%) in the low-dose group survived to hospital discharge ( P = 0.85). There was no difference in 28-day mortality in patients who received high-dose corticosteroids without tocilizumab compared with those who received low-dose corticosteroids with tocilizumab (n = 38\/82, 46% vs n = 19\/40, 48% P = 0.99); however, there was a higher mortality if patients received low-dose corticosteroids without tocilizumab (n = 39\/55, 71%, P = 0.01). The highest rate of a bacterial pneumonia was in patients who received high-dose corticosteroids with tocilizumab.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In critically ill patients with COVID-19 ARDS requiring mechanical ventilation, we found no difference in high- versus low-dose corticosteroids with regard to survival to hospital discharge. However, patients receiving only low-dose corticosteroids without tocilizumab did worse than the other groups. Larger prospective studies are needed to determine the optimal immunosuppression dosing strategy in this patient population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10600280221094571","type":"journal-article","created":{"date-parts":[[2022,5,20]],"date-time":"2022-05-20T12:29:55Z","timestamp":1653049795000},"page":"5-15","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["The Use of High-Dose Corticosteroids Versus Low-Dose Corticosteroids With and Without Tocilizumab in COVID-19 Acute Respiratory Distress Syndrome"],"prefix":"10.1177","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7177-4631","authenticated-orcid":false,"given":"Alyson","family":"Katz","sequence":"first","affiliation":[{"name":"Department of Pharmacy, NYU Langone Health, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"Altshuler","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, NYU Langone Health, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Papadopoulos","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, NYU Langone Health, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy","family":"Amoroso","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Critical Care, NYU Langone Health, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald","family":"Goldenberg","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Critical Care, NYU Langone Health, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Tarras","sequence":"additional","affiliation":[{"name":"Department of Medicine, NYU Langone Health, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelsey","family":"Krolikowski","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Critical Care, NYU Langone Health, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacklyn","family":"Hagedorn","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Critical Care, NYU Langone Health, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Fridman","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Critical Care, NYU Langone Health, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2258-9704","authenticated-orcid":false,"given":"Xian Jie Cindy","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, NYU Langone Health, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo","family":"Iturrate","sequence":"additional","affiliation":[{"name":"Department of Medicine, NYU Langone Health, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2092-3633","authenticated-orcid":false,"given":"Shari B.","family":"Brosnahan","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Critical Care, NYU Langone Health, New York, NY, 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